Cytotec, an ulcer drug used off-label by many doctors (and
nurse-midwives) to induce labor, is currently under
governmental scrutiny. And though it is not in any way
approved for obstetrical use by its manufacturer or the FDA,
doctors are defiantly continuing to use it; they are even
braggartly in their continued use of it.
Following are excerpts of letters written by spokespersons
both for Searle- Cytotec's manufacturer, and ACOG- the
American College of Obstetricians and Gynecologists;
afterwards is a column.
---
(Letter written to doctors by Searle:)
August 23, 2000
IMPORTANT DRUG WARNING CONCERNING UNAPPROVED USE OF
INTRAVAGINAL OR ORAL MISOPROSTOL IN PREGNANT WOMEN FOR
INDUCTION OF LABOR OR ABORTION
Dear Health Care Provider:
Cytotec administration...can cause abortion. Cytotec is not
approved for the induction of labor or abortion.
...Serious adverse events reported following off-label use
of Cytotec in pregnant women include maternal or fetal
death; uterine hyperstimulation, rupture or perforation
requiring uterine surgical repair, hysterectomy or
salpingo-oophorectomy; amniotic fluid embolism; severe
vaginal bleeding, retained placenta, shock, fetal
bradycardia and pelvic pain.
...Searle has not conducted research concerning the use of
Cytotec for cervical ripening prior to termination of
pregnancy or for induction of labor, nor does Searle intend
to study or support these uses...the effect of Cytotec on
the later growth, development and functional maturation of
the child when Cytotec is used for induction of labor or
cervical ripening has not been established.
Searle promotes the use of Cytotec only for its approved
indication. Further information may be obtained by calling
1-800-323-4204.
Michael Cullen, MD
Medical Director, U.S.
Searle
---
(Letter written to US government representatives in defense
of Cytotec by ACOG, with comments by me in brackets:)
October 11, 2000
Dear Senator Hutchinson and Representative Coburn:
...Misoprostol has been used for many years to induce labor
in women ready, but unable, to deliver healthy babies
without assistance. ["Unable"- could this man have an orgasm
if I were holding him at knife-point? The threat of drugs
and surgery to many trying-to-birth women do indeed feel
like- truly are!- "knife-point". The only thing "unable to
deliver" is the current hospital birth factory!]
Misoprostol, in these cases, helps ensure the delivery of
healthy babies and helps ensure the health and the life of
the mother, both by bringing the pregnancy to a safe
conclusion and by helping to prevent post-delivery
hemorrhaging. [Note how many times he says "health" in this
letter- saying the word does not bring it about... if he
cared about "health" of mother and child, why would he
choose to continue to use this drug? And inducing birth
causes hemorrhage... the fine doctor must surely know
this...? "Soft" words like "health" and "safe" do not make
labor inductions soft, healthful OR safe!]
In November 1999, ACOG's Committee on Obstetric Practice
published a Committee Opinion (#228), Induction of Labor
with Misoprostol, that endorsed the use of intravaginal
misoprostol tablets to induce labor in pregnant women with
unfavorable cervices. ["Unfavorable"? Cervixes just want to
snap up tight in resistance of the doctors' meddlesome
fingers! Birth becomes favorable when it is not prodded and
poked so unfavorably.]
The Committee recently reviewed the FDA data on adverse
events and other available scientific and clinical data in
light of Searle's warning. After this careful and extensive
review [yah, right], the Committee stands by its November
1999 recommendation on the use of misoprostol as a safe and
effective drug when used to induce labor and ensure the
delivery of healthy babies. [There's that "healthy" word
again. Although how it can apply to possible bradycardia or
death in babies I don't know...]
Sincerely,
Ralph W. Hale, MD, FACOG
Executive Vice President
[text in brackets done, with sincerity, by Leilah McCracken,
GMPWA (Grand Multipara With Attitude)]
---
(Now the column...)
Only a Devil Would Still Use Cytotec
I was talking to a woman today who is 29 weeks pregnant with
her first child. Her principle question was "how do I avoid
a cesarean section?" (She had "millions" of other concerns,
though she had just seen her doctor. Funny- pregnant women
always have "millions" of questions and concerns, but rarely
get them addressed by their busy, rushed, often impersonal
doctors.) I told her the best way to avoid a section is by
not giving birth in a place where an operating room is just
down the hall. Will she listen and give birth at home?- I
don't know. I do know, however, that her birth at the local
hospital where I had my fifth child will most likely be be
managed hyper-medically, and fraught with dangerous and
invasive, unproven procedures. (As most North American
births are, really.)
Anyway: many ACOG members just looooove Cytotec. Love it so
much, in fact, that they are disregarding drug company
warnings and governmental scrutiny in favor of its use on
pregnant women. Pregnant women! Again, the obstetrical cash
cows of modern medicine: herded like cows; as profitable as
cows; as big-eyed, dopey and naive as cows as they are
herded from waiting room to slaughterhouse. Pregnant women!!
I love them so much I want to fly- nay, teleport!!- to every
birth so I can slap fiddling, wounding hands away from women
and keep them safe for their births. No one else seems to be
there to do it for most of them! It kills me to know what's
happening to them, the women with "What to Expect When
You're Expecting" indelibly imprinted on their minds and
souls. Acquiescence; gullibility; "ask your doctor"; drop
your knees to whatever Big Daddy Doctor (and the Big Mommy
Doctor he dominates) wants to shove into you- even if it
makes your uterus rupture and your baby die... doctors know
full well that Cytotec kills. They know full well it makes
uteruses rupture... only a devil wouldn't care about the
harm such a drug causes.
In Marsden Wagner's brilliant article "Technology in Birth-
First Do No Harm" there is mention of one doctor who loves
Cytotec so much that he raves about it to his online
doctors' club- how it makes the cervix positively "mushie".
(mushie... the doctor risks maternal and fetal injury and
death in the pursuit of a "mushie" cervix...) But why the
want for a mushie cervix in the first place?- a fast birth.
And this is such an important point to make- the whole of
obstetrics is founded on procedures and interventions that
expedite the medical birth attendants' jobs, but offer
little benefit and bring outright harm to women (episiotomy
being the most infamous example) and babies. The Hippocratic
Oath certainly does not apply to obstetrics, a field of
medicine that exists solely to control and "correct"
women... the "harm" in "do no harm" cuts women to the
deepest cores of their beings.
The doctors have told us that Cytotec is here for good. In
the absence of massive lawsuits or fantastic acts of God,
they will continue to harm birth for their own monetary and
egotistical gain. ACOG has shown us, in their flamboyant
dismissal of Cytotec research and warnings, that they cannot
be trusted with the lives of women and babies; that they are
more interested in justifying their own careers and their
reactive, tinny positions as the societal gods of birth than
in genuinely finding out what the best way for women to give
birth really is. (And they will continue to help hunt down,
persecute and imprison the women who really do know what the
best way to give birth is- the lay midwives.) And drug
companies, despite their benevolent-sounding warnings, will
continue to sell drugs to the very doctors whom they warn
against.
To avoid a section, stay away from where they do sections.
To avoid a drugged and hazardous childbirth, stay away from
the executors of drugged and hazardous childbirth. Women-
stay home to give birth! Stay away from practitioners who
will manipulate your pregnancies and births as ways to
justify their own jobs. The harm that has come from the
medical establishment to birthing families is
incalculable... like the Searle doctor said- "the effect of
Cytotec on the later growth, development and functional
maturation of the child when Cytotec is used for induction
of labor or cervical ripening has not been established."
Cytotec may be used as a metaphor for ALL obstetrical
procedures- they are overwhelmingly unproven for women and
babies; rarely administered with true informed consent;
capable of causing great harm when administered by even the
most well-trained obstetrical provider. The true devastation
of medicalized birthing to individuals, society at large,
and the spirit of birth that exists as soundly as birthing
women themselves cannot even be fathomed. Only a devil would
know the pain obstetrical procedures bring... and still
continue to use them.
What will bring an end to birth death?- (birth death: the
replacing of female, glorious birth with medical nonsense)-
women claiming birth for themselves. What will finally make
doctors stop using Cytotec on women? Having no more women
waiting for them on their examining tables. Women, can't you
see this! Stop thinking your doctor only has your best
interest at heart. You are secondary to his/her efficiency
and profitability. It took me seven births to know the true
nature of childbirth: its ease, trustworthiness and beauty.
Don't take as long as I did. Stand up, for God's sake! Be
strong! Get off your backs and retain your place as Mothers.
Birth will only be healed when women say "my body, my baby,
my birth!'- and mean it.
There is one Voice, one Wisdom when it come to birth- that
of birth. Mind the birth... never mind the doctors who
endlessly, heartlessly, and thoughtlessly cut into it.
For the full Text of Searle's and ACOG's letters, go here-
<http://www.birthlove.com/pages/acog_searle.html>
"Technology in Birth- First Do No Harm"-
<http://www.midwiferytoday.com/articles/technologyinbirth.htm>
More about obstetrical cash cows-
<http://www.birthlove.com/pages/bl_cols/moses.html>
Resexualizing Childbirth-
<http://www.birthlove.com/pages/resex.html>
****************************
Robert Modugno MD MBA FACOG
Marietta, GA
